Acute Stroke: Imaging The Ischaemic Penumbra With Perfusion CT
Funder
National Health and Medical Research Council
Funding Amount
$243,000.00
Summary
The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressivel ....The burden of stroke is large. Clot-dissolving medication (thrombolysis) may dramatically improve the outcome of many patients with severe stroke by unblocking the affected brain artery. However, very few patients receive this medication, as the current approval is restricted to treatment within 3 hours of stroke onset. The major aim of thrombolysis is to rescue brain tissue with reduced blood flow (the ischaemic penumbra) from becoming irreversibly damaged (infarcted). The penumbra progressively becomes infarcted over the next 48 hours if blood flow is not restored by the blood clot in the brain artery being dissolved. Penumbral brain tissue cannot be identified with clinical assessment or standard CT scanning. New generation CT scanners are capable of assessing brain blood flow. Perfusion CT imaging (CTP) is well tolerated and time-efficient, and can be integrated into the brain CT scanning process performed on all stroke patients. Preliminary evidence suggests that CTP can distinguish between tissue that represents the ischaemic penumbra, and tissue that is already permanently injured. This project aims to validate the use of CTP in imaging the ischaemic penumbra. This will be based on testing the accuracy of CTP tissue signatures of the penumbra in predicting clinical outcome and final stroke size. This is the only national collaborative study planned worldwide for this relatively new but increasingly accessible imaging technique. The ability to rapidly identify under-perfused but still viable brain with CTP would add new and exciting management options to the routine emergency assessment of stroke patients. The results of this unique study could have a significant impact on the management of acute stroke worldwide. If validated, it is anticipated that CTP would be widely used to improve patient selection for stroke thrombolysis, especially in safely extending the time window so that a greater number of patients can be treated with better outcomes.Read moreRead less
Towards Predicting Brain Deformations For Image-guided Neurosurgery
Funder
National Health and Medical Research Council
Funding Amount
$304,281.00
Summary
We will significantly improve the efficiency of image-guided neurosurgery for brain tumours by creating a novel system to improve intra-operative visualisation and navigation utilising realistic prediction of brain deformations based on a biomechanical model. The system will create an augmented reality visualisation of the intra-operative configuration of the patient's brain merged with high resolution pre-operative imaging data in order to better localise the tumour and critical healthy tissues ....We will significantly improve the efficiency of image-guided neurosurgery for brain tumours by creating a novel system to improve intra-operative visualisation and navigation utilising realistic prediction of brain deformations based on a biomechanical model. The system will create an augmented reality visualisation of the intra-operative configuration of the patient's brain merged with high resolution pre-operative imaging data in order to better localise the tumour and critical healthy tissues.Read moreRead less
Development And Validation Of A Finite Element Model For Orthopaedic Screw Insertion Into Trabecular Bone
Funder
National Health and Medical Research Council
Funding Amount
$420,454.00
Summary
Osteoporosis is a disease of the bones that results in reduced bone strength and susceptibility to fragility fractures. Due to the spongy nature of osteoporotic bone, surgeons face major difficulties in obtaining secure fixation of bone screws. Our aim is to develop and validate a computer model of orthopaedic screw insertion into trabecular bone based on micro-computed tomography image data. This will allow an assessment of the most appropriate screw designs for stable fixation of implants.
Infrared Spectroscopic Imaging In The Diagnosis Of Cervical Cancer
Funder
National Health and Medical Research Council
Funding Amount
$291,600.00
Summary
In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to pro ....In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to probe smears shows promise in providing such an easily automated reliable method. We, and others have spent a number of years exploring this technique and have solved a number of the problems associated with it. Based on our work in the field and the work of others we now wish to develop a methodology using an infrared micro-imaging spectrometer combined with multivariate statistics that can be used to diagnose cervical cancer and the conditions that lead to cervical cancer.Read moreRead less
Improved Identification Of At-risk Brain Tissue In Patients With Stroke
Funder
National Health and Medical Research Council
Funding Amount
$279,044.00
Summary
Stroke is one of the most frequent causes of death and the major cause of adult neurological disability. Diagnostic tools to improve its management are therefore crucial. This project is dedicated to improving the magnetic resonance imaging techniques for measuring blood flow to the brain, and to applying these to patients who have had a stroke. Improved methods will enable better prediction of tissue outcome following stroke, thus enabling optimal early management decisions to be taken.
Brain surgery for the treatment of epilepsy is associated with a risk of cognitive impairment. Avoidance of disabling post-operative impairments depends in large measure on our ability to predict and measure individual patterns of language lateralization prior to neurosurgical intervention. Typical patterns of lateralisation cannot be assumed in patients with epileptogenic lesions. There appears to be a consensus that atypical representation is more frequent in patients with epilepsy than it is ....Brain surgery for the treatment of epilepsy is associated with a risk of cognitive impairment. Avoidance of disabling post-operative impairments depends in large measure on our ability to predict and measure individual patterns of language lateralization prior to neurosurgical intervention. Typical patterns of lateralisation cannot be assumed in patients with epileptogenic lesions. There appears to be a consensus that atypical representation is more frequent in patients with epilepsy than it is in the normal population, and values above 20% are not unrepresentative Partial epilepsy arises from a region in the brain and spreads to involve other areas. This is contrasted with generalised epilepsy, which appears to arise all over the brain simultaneously. Partial epilepsy is often associated with lesions such as tumors or hippocampal sclerosis, and often seizures are intractable. Patients with partial epilepsy have a number of sources of brain damage in the language areas. Primary brain changes may be pre-existing, which means they pre-date the onset of habitual seizures. They may consist of a focal developmental abnormality (a malformation of cortical development) or may represent a general genetic predisposition to seizures. Therefore, partial epilepsy is not only associated with severe abnormalities in epileptogenic region but also with additional widespread abnormalities in both hemispheres. There is also evidence for a correlation of abnormalities with seizure frequency with some suggestion that the duration of epilepsy may also increase the degree of abnormality in the hemisphere. The neuronal conditions in language cortex that give rise to altered lateralisation in function are currently not known. The primary aim of this study is to understand reorganisation of the language system in epilepsy by using the current most sensitive non-invasive methods of assessing brain damage and brain function, using magnetic resonance imaging.Read moreRead less
Diagnostic And Prognostic Evaluation Of Diffusion Tensor Imaging And Cognitive Function After Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$874,404.00
Summary
Traumatic brain injuries (TBIs) are a common cause of brain damage, leading to a variety of disabling cognitive problems. This study will evaluate the ability of new brain imaging techniques and cognitive tests to detect previously undiagnosed brain damage and to predict patient outcome following TBI in order to improve the health care and treatment of these patients. It will also examine the contribution of other factors (eg. injury type, age, pre-injury cognitive ability) to outcome.
Molecular Imaging Of Brain Tumour Therapeutic Efficacy
Funder
National Health and Medical Research Council
Funding Amount
$412,200.00
Summary
The prognosis for malignant brain tumour patients that do not respond to intial treatment strategies is very poor. The fact that many of these patients patients will not survive longer than 12 months post diagnosis underscores the need to make treatment management decisions in a timely manner. This project seeks to develop and validate non-invasive early molecular imaging biomarkers that can quantify treatment efficacy months before traditional measures of efficacy are valid.